Director, Revenue Cycle Management

Director, Revenue Cycle Management

(Healthcare Finance & Operations)

About the Role

We are seeking an experienced and strategic Revenue Cycle Management leader to oversee and optimize end‑to‑end revenue cycle operations. This role is ideal for a driven healthcare finance professional who enjoys leading teams, improving systems, and partnering across the organization to strengthen financial performance while maintaining the highest standards of compliance and integrity.

You will play a critical leadership role across billing, coding, collections, denial management, credentialing, and payer relations—while serving as a trusted financial partner to operational and clinical leaders.

What You’ll Do

Revenue Cycle Leadership

• Lead and oversee all aspects of the revenue cycle, including billing, collections, denial management, and credentialing.
• Provide direct leadership and mentorship to mid‑level revenue cycle and credentialing managers.
• Partner with leadership on coding strategy and payer relations initiatives.
• Ensure accurate, timely, and compliant claim submission, payment posting, and collections.
• Design and continuously improve billing and coding workflows to maximize reimbursement and ensure compliance with payer and regulatory requirements.

Compliance & Regulatory Excellence

• Ensure revenue cycle operations comply with all federal, state, and payer regulations (HIPAA, ICD‑10, CPT, HCPCS, and payer‑specific guidelines).
• Lead and participate in coding, billing, and documentation audits to proactively identify and resolve issues.
• Serve as a key contributor during internal and external financial audits.

Denial Management & Revenue Optimization

• Oversee denial management processes, partnering with billing teams to analyze root causes and reduce denial and rejection rates.
• Implement strategies to improve first‑pass claim acceptance and accelerate payment turnaround times.

Budgeting, Forecasting & Cost Analysis

• Contribute to the development and management of operational budgets, forecasts, and financial models.
• Conduct cost and variance analyses to support decision‑making, improve efficiency, and identify savings opportunities.

Process Improvement & Systems Optimization

• Continuously evaluate and enhance financial systems, workflows, and controls to drive efficiency and reduce risk.
• Champion automation and technology solutions to streamline revenue cycle processes and improve performance.

Payer Relations & Credentialing

• Serve as a collaborative point of contact for payer issues, including disputes, denials, and reimbursement challenges, while partnering closely with senior leadership.
• Provide direct oversight of the credentialing department, ensuring timely payer enrollment and ongoing compliance with payer requirements.

Representative Payee Oversight

• Oversee the representative payee program, ensuring full regulatory and operational compliance.

Strategic Support for Business Units

• Partner with operational leaders to provide financial insight and guidance that aligns revenue cycle performance with organizational goals.

Leadership & Collaboration

• Lead, mentor, and develop a high‑performing team of revenue cycle and financial operations professionals.
• Foster a culture of accountability, continuous improvement, and cross‑functional collaboration.
• Work closely with the Director of Finance to align on reporting, compliance, and cost optimization initiatives.

Reporting & Strategic Insights

• Prepare and present regular revenue cycle performance reports to senior leadership.
• Translate data into actionable insights and recommendations that strengthen financial outcomes.

Education & Training

• Provide education and training to clinical, billing, and coding teams on revenue integrity, coding standards, and regulatory requirements.

What You Bring

Required Qualifications

• Education: Bachelor’s degree in healthcare administration, finance, accounting, business, or a related field (Master’s degree preferred).
• Experience: 7–10+ years of progressive experience in healthcare revenue cycle management or financial operations, including leadership responsibility.
• Expertise: Strong knowledge of healthcare billing, coding, payer rules, reimbursement models, and regulatory compliance (ICD‑10, CPT, HCPCS).
• Leadership: Demonstrated ability to lead, mentor, and inspire teams while collaborating effectively across departments.
• Analytical Skills: Proven strength in financial analysis, problem‑solving, and data‑driven decision‑making.
• Communication: Excellent written and verbal communication skills with the ability to educate and influence diverse stakeholders.
• Attention to Detail: Ability to manage multiple priorities in a fast‑paced environment while maintaining accuracy and compliance.
• Strategic Mindset: Ability to think broadly, anticipate challenges, and align revenue cycle strategies with organizational goals.

Preferred Qualifications

• Experience in hospital systems, physician groups, large medical practices, or community‑based healthcare settings (including mental health).
• Familiarity with financial reporting and analytics tools such as Power BI or Tableau.
• Experience with denial management strategy and payer contracting.
• Bilingual (English/Spanish) a plus.

Why This Role Matters

This position offers the opportunity to make a meaningful impact by strengthening financial sustainability, improving processes, leading talented teams, and supporting care delivery through strong revenue cycle performance.
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